Pharmaceutical Benefit Scheme changes to spasticity treatment

People with muscle spasticity after stroke now have more access to botulinum toxin A treatment (brand names Botox and Dysport), thanks to recent changes to Australia’s Pharmaceutical Benefits Scheme (PBS).

Muscles have a certain amount of tone, which is controlled by signals from the brain. Muscle spasticity happens when the part of your brain that sends these control signals is damaged and the muscle pulls too hard.

Around 30 percent of stroke survivors will experience some form of muscle spasticity. Some people experience spasticity immediately after their stroke, but it can start at any time.

Botulinum toxin A can be injected into muscles in order to reduce this overactivity. This is used as part of a rehabilitation program, combined with physiotherapy or occupational therapy. Botulinum toxin A treatment provides a window of opportunity for stroke survivors to work with their therapists to strengthen muscles, improve movement and function.

The PBS changes mean the cost of botulinum toxin A for appropriate stroke patients is subsidised by the Federal Government. The treatment has been made more affordable, and therefore more accessible, for the treatment of both upper and lower limb spasticity.

Lower limb

The PBS has subsidised the cost of Botox for people with muscle spasticity in their lower limb for the first time. Treatment is available, where appropriate, to people with spasticity in the leg muscles, including a stiff knee or pointed foot.

For more detail including rules about treatment, go to: http://www.pbs.gov.au/medicine/item/10993N-10997T-10998W-10999X-11000Y-11004E-11016T-11023E-11751L

Look through the Code and Prescriber column to find item code 10998W and click on Authority Required (in red).

Upper limb

The PBS has subsidised the cost of Dysport, where appropriate, for people with muscle spasticity in their shoulder, arm, wrist or hand. Treatment was previously available to people with spasticity in their upper limb, but only as a single course of treatment. This has changed to:

• Four treatment periods per upper limb in the first year of treatment.
• Two treatment periods per upper limb permitted each year thereafter.

This will be welcome news for people who have had one course of treatment in the past and would like to see if further treatment may be appropriate for them.

The PBS has also removed their previous three-month waiting period, which means that now treatment can start at any time after stroke.

For more detail including rules about treatment, go to https://www.pbs.gov.au/medicine/item/10981Y-10982B-10987G-10988H-11006G-11007H-11015R-11022D

Look through the Code and Prescriber column to find item code 10982B and click on Authority Required (in red).

More information and advice

StrokeLine can help with information – call 1800 787 653.

See your GP or specialist for information and advice.

The Stroke Foundation fact sheet provides more information on muscle spasticity:

https://enableme.org.au/FactSheets/Muscle-spasticity-after-stroke-fact-sheet